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Therapeutic options in the treatment of inflammatory glaucoma

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Kaczmarek J., Wolińska N., Pigoński A., Papież M., Pyza A., Alsoubie I., Papachristoforou N., Piórek J., Ueno A., Sajak-Hydzik K., Pawlicka I., Piskorz A., Kozak M., Roszkowska A. M.
OphthaTherapy
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2024
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vol. 11
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issue 3
244-251
EN
Therapeutic options in inflammatory glaucoma, both pharmacological and surgical methods, have been presented in this paper. Main goals of pharmacotherapy are: controlling inflammation and reducing intraocular pressure. Anti-inflammatory drugs primarily include topical glucocorticosteroids but also nonsteroidal anti-inflammatorydrugs and immunomodulatory therapy. Elevated intraocular pressure is treated with β-blockers, carbonic anhydrase inhibirozpotors, prostaglandin analogues and α2-adrenergic receptor agonists. If pharmacological treatment does not produce the desired results, surgical treatment must be considered. Due to the risk of reactivation of inflammation, it is recommended that it be performed 3 months after the inflammation has healed. Currently, trabeculectomy remains the gold standard. Among the invasive treatment techniques, we discuss trabeculectomy with the use of mitomycin C, micro-hook trabeculectomy, laser therapy, glaucoma drainage implants, deep sclerectomy and viscocanalostomy.
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Malignant glaucoma: disease course and treatment

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Papachristoforou N., Alsoubie I., Ueno A., Pyza A., Kaczmarek J., Wolińska N., Piórek J., Sajak-Hydzik K., Pawlicka I., Piskorz A., Kozak M., Roszkowska A. M.
OphthaTherapy
|
2024
|
vol. 11
|
issue 2
200-205
EN
Diagnosis of malignant glaucoma presents a challenge due to subtle symptoms in early stages of the disease, making increased intraocular pressure a pivotal indicator, often accompanied by inflammation and corneal edema. Diagnostic modalities, including ultrasound biomicroscopy and anterior segment optical coherence tomography, play crucial roles in visualizing anatomical changes in the ciliary body and anterior chamber. The classic slit lamp examination, complemented by tonometry, remains a fundamental diagnostic tool. A stepwise therapeutic approach is essential, beginning with pharmacological interventions aimed at intraocular pressure reduction and subsequent restoration of the anterior chamber configuration. The first stage of treatment is pharmacotherapy. Laser therapies, such as iridotomy and Nd:YAG laser treatment, address angle closure. In resistant cases, a surgical approach, such as irydo-zonulo-hialoidotomy may be considered.
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